Background and objective: This study aims to understand worker perceptions toward care farming in the context of acceptability in leisure and welfare facilities for the elderly by examining the worker perceptions toward new programs, analyzing the correlation between care farming partnerships and acceptability, and deriving implications.

Methods: To address these goals, this study employed a theoretical review of care farming and relevant partnerships and conducted a non-face-to-face survey of 59 workers of leisure and welfare facilities for the elderly. The collected data is analyzed using SPSS 26.

Results: The results show that workers have negative perceptions toward current human and financial resources, but positive perceptions toward opportunities for activities and vitalizing the community. Workers also perceived that there is a need for partnership with external agencies for financing. There were also positive correlations between financial status and long-term management, indicating that a proper financing system can improve acceptability.

Conclusion: In order to improve the acceptability of care farming in leisure and welfare facilities for the elderly in South Korea, it is necessary to involve more external stakeholders, especially care farming experts. There must also be a partnership-based financing system to solve financial problems. In addition, the manpower support system must be improved by building a community of their own. These implications will contribute to improving the acceptability of care farming in leisure and welfare facilities for the elderly in South Korea.

Key words: care farming expert, governance, income generation, partnership

Introduction

Research background

Research background

Rapid population aging is giving rise to social problems as well. Accordingly, interest in welfare facilities for the elderly has also increased to improve the quality of life of the elderly population. However, the issues of satisfaction and quality improvement of facilities for the elderly are also raised (Cha, 2012), along with mental problems in senescence (Kwon and Kim, 2016; Lee and Yang, 2019). Accordingly, alternatives are suggested for providing programs in facilities and improving mental health, and recently, a methodology that interacts with humans through plants as a medium is receiving attention (Kim et al., 2016). In particular, care farming for the purpose of healing is familiar to the elderly (RDA, 2021), and they are more interested due to its effectiveness in mental improvement (Shin, 2006). Care farming is the use of farming and rural landscapes to provide healing (Hassink and van Dijk, 2007; Hine et al., 2008; Sempik et al., 2010; RDA, 2013). Its contribution to mental health is already widely known, raising the need for its adoption. However, despite the theoretical background, it is questionable whether care farming is empirically applied to actual welfare facilities for the elderly. In other words, verification of acceptability is required, but related research is difficult to find. Acceptability is defined as stakeholder expectations as a key concept (Johnson et al., 2014). Studies related to acceptability and plant mediation include overseas studies such as Nam and N. Dempsey (2018, 2019, 2020) about citizen farms, grassland planting participation, and financing, as well as domestic studies on operating parks and green spaces (Choi et al., 2022), creating green spaces (Nam and Bae, 2021a), and management (Nam and Bae, 2021b). However, what is important for acceptability in this study is the awareness of major stakeholders and the network of various stakeholders. In other words, the understanding and importance of partnership, that is, the participation of various stakeholders with the concept of responsibility sharing, along with the recognition of workers as operating entities are also being raised. However, research related to this is difficult to find. In order to improve the acceptability of care farming for leisure and welfare facilities for the elderly, research on the perception of facility workers as the participants must be conducted first, based on which there must also be research on domestic acceptability of care farming partnerships. Accordingly, the following research objectives are set up: 1) understanding the perception of workers in leisure and welfare facilities for the elderly toward partnership, 2) correlation analysis of facility operation status and acceptability of care farming, and 3) implications for improving acceptability of care farming in leisure and welfare facilities for the elderly.

Care farming and partnership

Care farming and partnership

Care farming emphasizes the importance of a smooth partnership between participants, that is, a stakeholder network including the public and private sectors (Kim et al., 2019). In particular, Europe, the United States, and Japan are constantly striving for the continuous development of care farming by establishing a care farming network (RDA, 2021). In addition, they are also establishing related policies by building a national network to develop care farming and expand the knowledge base. Some typical examples are Community of Practice Farming for Health (CoP FFH) and Social Farming (SoFar), and their activities are as shown in (Table 1).

The cases in Table 1 show that advanced countries are using partnership networks for activation and constant development of care farming. The important thing here is that they are trying to understand stakeholder perceptions and that they always reflect the perceptions of workers as operating entities. Partnership is generally collaboration to seek mutual benefits, but here, the concept of partnership is defined as responsibility sharing because it is for non-profit purposes, and the participation and activities of various stakeholders are emphasized. South Korea is also anticipating positive effects by adopting care farming in welfare facilities for the elderly. However, research on acceptability is needed to continuously experience and maintain these effects, and it is necessary to first understand partnership and perception of operating entities.

Research Methods

Participants

Participants

This study selected workers of leisure and welfare facilities for the elderly as the participants, who are the providers of care farming as well as stakeholders. A survey was conducted on 80 workers of 3 facilities located in Mokpo and 1 facility located in Gwangju.

Analysis method

Analysis method

This study was conducted for total 9 days from July 21 to 29, 2022, and a non-face-to-face survey was conducted to analyze the difference in perception of partnership among workers and partnership cooperation according to demographics, correlation between facility operation status and acceptability of care farming, and implications for improving acceptability of care farming in leisure and welfare facilities for the elderly. The contents of the survey were divided into three categories: accessibility, facility and program operation status, perception/need (acceptability) of care farming and partnership. Total 80 copies of the questionnaire were distributed, but 59 copies were used in the analysis excluding insincere responses.

Survey items

Survey items

The survey indices of this study were derived based on the indices of previous studies. Bea et al. (2019) presented 5 categories for revitalization of care farming: improvement of accessibility, improvement of promotion and information provision, diversification of facilities and programs, economic support, and expansion of professional manpower and institutions. RDA (2013) classified healing activities into economic or financial factors, facility or infrastructure factors, expertise factors, and institutional or administrative factors to investigate obstacles or difficulties in carrying out healing activities. Finally, Johnson et al. (2014) claimed that indices for acceptability must be examined from the perspective of stakeholder perceptions, and the degree of risk, profit, and positive/negative response of stakeholders must be considered. Therefore, this study selected accessibility and facilities and program operation status as basic data indices that can reflect worker perceptions toward promoting care farming in leisure and welfare facilities for the elderly, and awareness/need of care farming and partnership (acceptability) as perception indicators about acceptability (Table 2).

There were transportation and convenience of public transportation in the accessibility sector; and space, financial status, employee status for program implementation, program partnership status with external agencies, diversity of programs, and agricultural and horticultural program status in the facilities and program operation status sector. Finally, basic awareness of care farming and matters to consider when adopting care farming (profitability, activity opportunity, etc.), and perception of the need for partnership with external agencies were presented in the awareness/need of care farming and partnership (acceptability) sector.

Data analysis

Data analysis

The research data obtained through the survey were analyzed using SPSS ver.26, a statistical package program. Frequency analysis, descriptive statistics, and t-test were used to analyze the worker perceptions toward partnership and the difference in perceptions toward partnership according to demographics. We also conducted correlation analysis and cross-tabulation analysis to determine the correlation between facility operation status and acceptability of care farming. Based on the results derived from this statistical analysis, we provided implications for improving the acceptability of care farming.

Results and Discussion

General characteristics of respondents

General characteristics of respondents

There were total 59 respondents (19 male and 40 female respondents), and 9 respondents were aged 20–29 (15.3%), 11 aged 30–39 (18.6%), 25 aged 40–49 (42.4%), 12 aged 50–59 (20.3%), and 2 aged 60 or older (3.4%). There were 26 social workers (44.1%), followed by 11 office workers (18.6%), and except other respondents including public service workers, the duties seem limited instead of diverse. Finally, 7 respondents have worked for less than 1 year (11.7%), 20 for 1–3 years (33.9%), 8 for 3–5 years (13.6%), 3 for 5–7 years (5.1%), and 21 for 7 years or more (35.6%) (Table 3).

Analysis of perceptions toward partnership

Analysis of perceptions toward partnership

Descriptive statistics

Descriptive statistics

To examine the response tendency for all items except demographic items, a 5-point Likert scale is used to conduct descriptive statistics by classifying the items by positivity and negativity into strongly disagree (1 point), disagree (2 points), average (3 points), agree (4 points), and strongly agree (5 points) (Table 4).

As a result of the analysis, in accessibility, 1a (transportation) scored 3.86 points and 1b (convenience of public transportation) 3.93 points, indicating that the current facility accessibility is perceived as sufficient. In facilities and program operation status, 2a (space) scored 3.70, 2b (financial status) 3.42, and 2c (manpower) 2.92, showing that the current facilities and manpower were not perceived as sufficient. Moreover, 2d (partnership for current program), 2e (long-term management), and 2f (diversity of programs) scored between 3.5 and 4.0, thereby sufficient, and 2g (need for new programs) was high at 4 points. This indicates that workers perceive the need to adopt new programs to the current facilities. In awareness/need of care farming and partnership (acceptability), 5b (need for partnership between welfare facilities and external agencies when adopting care farming programs) scored highest at 4.37, followed by 4b (opportunities for activities of the elderly when adopting care farming programs) and 5a (need for financial cooperation to implement current programs) at 4.25, whereas 4a (profitability of facilities when adopting care farming) scored relatively low at 2.92.

In sum, workers of leisure and welfare facilities for the elderly seemed to need partnership the most when applying care farming programs. Moreover, they were perceiving manpower shortages for current program operation, and attached importance to the positive benefits gained by participants rather than the profitability of care farming facilities. In other words, to promote acceptability of care farming in leisure and welfare facilities for the elderly, there is a need for help through partnership, especially professional manpower supply for the programs.

Analysis of perception differences toward partnership according to demographic characteristics

Analysis of perception differences toward partnership according to demographic characteristics

First, a t-test was conducted to examine the perception differences by gender. Detailed items of accessibility, facilities, program status, and diversification among survey indices were used in the analysis, and the following results showed that there was a statistically significant perception difference by gender (Table 5).

The results showed that there was a difference in space for programs (t = 2.762, p = .008), financial status (t = 2.563, p = .013), long-term management of programs (t = 2.275, p = .027), diversity of programs in the current facilities (t = 2.963, p = .004), and need for new programs (t = 2.671, p = .010). The means of space and financial status, long-term management, and diversity of programs were relatively higher in male than female respondents, implying that male respondents perceive there are sufficient finances (space, financial status), long-term management, and diversity of programs more than female respondents. However, the need for new programs showed a higher mean in female participants, which suggests that female respondents think more positively toward adopting new programs. Second, a cross-tabulation analysis was conducted to determine the perception differences by duty. The results showed that there was a difference in the need for new programs (χ² = 58.307, p = .031) and the awareness of the positive effect of care farming (χ² = 88.864, p = .000) (Tables 6, 7).

30 out of 59 participants (50.8%) answered “yes” to the need for new programs, indicating that more than half of the participants felt the need to adopt new programs. The most were social workers (15 participants), and the least were care workers. In addition, the percentage of respondents who answered ‘agree’ or ‘strongly agree’ to the perception of the positive effects of care farming was the highest among social workers (18 participants, 30.5%), and the lowest among nurses (assistants) (1 participant, 1.7%). In other words, it seems that social workers and office workers were in more need of new programs compared to other duties.

Facility operation status and correlation analysis of each variable of acceptability of care farming

Facility operation status and correlation analysis of each variable of acceptability of care farming

First, Pearson correlation coefficient was used to determine the correlation of each variable of acceptability of care farming and facility and program operation status. Total 9 variables that are detailed items of facility and program operation status and acceptability among survey indices were used in the analysis, such as financial status, perception, need for partnership, diversity of programs, long-term management, profitability of care farming, opportunities for activities, participation cost, and activating the community. In particular, space, financial status, and manpower were combined to use as financial items in the analysis. As a result of the correlation analysis, there were 11 positive correlations and 1 negative correlation (Table 8).

The results are as follows. There were positive correlations in financial status-diversity of programs(r = .569), financial status-long-term management(r = .323), care farming perception-opportunities for activities(r = 323), need for partnership-opportunities for activities(r = 561), need for partnership-participation cost(r = .471), need for partnership-activating the community(r = .489), diversity of programs-long-term management(r = .711), opportunities for activities-participation cost(r = .554), opportunities for activities-activating the community(r = .536), and participation cost-activating the community(r = .501), and a negative correlation in long-term management-profitability(r =−.354). In other words, diversity of programs-long-term management showed high correlation, and diversity of programs-financial status, financial status-long-term management, need for partnership-opportunities for activities, opportunities for activities-participation cost, opportunities for activities-activating the community, participation cost-activating the community had a correlation.

In sum, financial status of current facilities had a correlation with diversity of programs and long-term management, and there was also a correlation between partnership and opportunities for activities. When adopting care farming, there was a correlation between opportunities for activities, participation cost, and activating the community. In other words, diversity of programs and long-term management will increase if there are sufficient finances for the facilities, and the need for partnership in adopting care farming will have a positive effect in opportunities for activities, participation cost, and activating the community. Moreover, to increase acceptability of care farming, it is necessary to establish financing plans considering that various programs can be operated when there are sufficient finances for the facilities, and also to develop care farming programs considering opportunities for activities, participation cost, and activating the community.

Second, as a result of conducting a cross-tabulation analysis to determine the correlations of detailed items of facility operation status and acceptability, it was found that there were correlations in need for new programs-opportunities for activities (χ² = 26.138, p = .010), need for new programs-need for partnership between leisure and welfare facilities for the elderly and external agencies when adopting care farming programs (χ² = 26.728, p = .008), horticultural program operation status within the current facilities-need for financial cooperation with external agencies (χ² = 18.444, p = .018), and horticultural program operation status within the current facilities-need for partnership with external agencies when adopting care farming programs (χ² = 23.728, p = .022). In sum, it is necessary to develop programs considering cooperation through partnerships and opportunities for activities when adopting care farming with new programs. This result is similar to the study by Bae et al. (2019), which revealed that it is necessary to establish manpower and cooperative agencies through partnership to diversify care farming programs. In other words, various programs considering the opportunities for activities must be prepared when adopting care farming programs, and partnerships with various agencies will help increase acceptability of care farming. Furthermore, considering that ‘strongly agree’-’strongly agree’ showed the highest ratio of responses regarding the need for financial cooperation and partnership with external agencies regardless of the operation of horticultural programs within the current facilities, cooperation through partnership with external agencies when adopting care farming will help increase acceptability of care farming.

Challenging the status quo of increasing acceptability

Challenging the status quo of increasing acceptability

Based on the perception of workers of leisure and welfare facilities for the elderly, this study derived results of acceptability of care farming with focus on partnership. However, based on the results of the analysis such as perception toward shortage of manpower in charge of programs, need for partnership when adopting care farming, and correlation between finances and new programs, it is necessary to provide additional discussions and implications to improve acceptability. Accordingly, this study proposes the following implications.

First, there is a need for empirical public-private partnership based on the participation of outside experts. Workers in this study had a negative perception toward poor human resources within the facilities. On the other hand, they had a positive perception toward partnership with external agencies when adopting new programs and financial cooperation to implement the programs within the current facilities. Furthermore, considering that there was a positive correlation between financial status and diversity of programs, support for external partnership related to care farming is essential. There is also a need for continuous research. Domestic studies on care farming were mostly on facility operation, program survey, and elderly, such as space and program operation status and the possibility of implementation (Cha, 2012), horticultural activities for the elderly to improve leisure education for the elderly (Cha, 2021), horticultural therapy programs to relieve depression of low-income elderly (Lim, 2017), qualitative research on care farming in social welfare (Lee et al., 2020), and a survey on horticultural therapy in welfare facilities for the elderly in Seoul (Lee et al., 2011). This indicates that there is insufficient research considering empirical partnership in adopting care farming in welfare facilities for the elderly. According to RDA (2021), social welfare facilities providing care farming programs were using processional manpower from the outside in addition to social workers in charge of the programs, which is due to the low expertise of facilities workers about care farming (RDA, 2021). This raises the need to conduct research on perception of various care farming experts such as care farmers, and implies the need to share responsibilities about supporting partnership with care farming experts like care farmers in the public sector.

Second, it is necessary to promote financing based on partnership. In this study, it was found that the diversity of programs increased when there were sufficient finances in the facilities, which also improved the adequacy of long-term management. In addition, facility workers are showing high positive perceptions toward financial cooperation for ongoing programs. This partnership is expected to have a positive effect on opportunities for activities through care farming, reasonable participation cost, and activating the community. According to literature review, it is necessary to secure material and human resources and cover labor costs for professional manpower and finance the programs at the government and local government level in order to promote care farming programs. Most social welfare facilities operating care farming were receiving help from local agricultural technology centers (RDA, 2021). In other words, this implies the need for the public sector’s participation in partnership including agricultural technology centers in order to promote care farming in leisure and welfare facilities for the elderly.

Third, an expanded governance manpower support system based on its own community structure is needed. Care farming is an activity that emphasizes the importance of sustainable management after the adoption. To this end, there is a need to expand human resources. The participants had negative perceptions toward the adequacy of management due to limited duties and lack of physical and financial resources, and manpower sufficiency showed a lower mean than financial status and space in the results of descriptive statistics. In other words, there may be insufficient manpower to be in charge of or managing care farming even after adopting it. Previous studies argued that governance systems based on communities among various stakeholders were actively used in management, and they were emphasizing the vitalization of human resources based on community participation through the governance system, such as positivity in the community-led management system in the long run (Nam, 2021), importance of community participatory education (Sanders, 2003), and community participatory education at school and home (Epstein, 2008). In other words, it is necessary to be a part of human resources by building a community and making decisions as facility users. This governance manpower support system by building the community will be a great resource for long-term management.

Improving such implications will ultimately contribute to improving acceptability of partnership-based care farming <Fig. 1>.

Conclusion

This study surveyed and analyzed the current facility operation and program status as well as perceptions toward partnership among workers of leisure and welfare facilities for the elderly and derived perceptions toward the need for partnership when adopting care farming and the correlation between facility operation and program status and acceptability indices. The research was conducted to improve acceptability of care farming at leisure and welfare facilities for the elderly.

The results are as follows. First, workers had negative perceptions toward the current employee status, and positive perceptions toward opportunities for activities, reasonable participation cost, and activating the community when adopting care farming. Second, they perceived that there is a need for financial cooperation for ongoing programs as well as partnership with external agencies in adopting care faming. Third, there was a correlation between financial status, diversity of programs, and long-term management, which implies that acceptability of care farming at leisure and welfare facilities for the elderly can be increased by establishing a financing system.

Three implications are provided based on these results. First, there is a need for public-private partnership through participation of outside experts to promote care farming in leisure and welfare facilities for the elderly. Moreover, since there are many experts with various private licenses aside from care farmers holding a national license, it is necessary to conduct research based on the perceptions of care farming experts. Second, alternatives to realistic financial problems in the private sector must be presented by establishing a partnership-based financing system. Third, the governance manpower support system must be improved by building a community. These implications raise the need to apply partnership-based care farming in order to increase acceptability of care farming in leisure and welfare facilities for the elderly.

However, this study has limitations in that it failed to reflect the perceptions of care farming experts such as care farmers as suggested in the implications, and that the results cannot be generalized considering the small sample size of the survey and the different ratios of duties from the start, which leaves room for further research.

Notes

This work was supported by the National Research Foundation of Korea(NRF) grant funded by the Korea government(MSIT) (No. 2022R1G1A1013266)

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